Discovery of ((4R,5S)-5-Amino-4-(2,4,5 ... - ACS Publications

Oct 7, 2006 - Dipeptidyl peptidase IV (DPP4) deactivates glucose-regulating hormones such as GLP-1 and GIP, thus, DPP4 inhibition has become a useful ...
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J. Med. Chem. 2006, 49, 6439-6442

Discovery of ((4R,5S)-5-Amino-4-(2,4,5trifluorophenyl)cyclohex-1-enyl)-(3(trifluoromethyl)-5,6-dihydro[1,2,4]triazolo[4,3-a]pyrazin-7(8H)-yl)methanone (ABT-341), a Highly Potent, Selective, Orally Efficacious, and Safe Dipeptidyl Peptidase IV Inhibitor for the Treatment of Type 2 Diabetes Zhonghua Pei,* Xiaofeng Li, Thomas W. von Geldern, David J. Madar, Kenton Longenecker, Hong Yong, Thomas H. Lubben, Kent D. Stewart, Bradley A. Zinker, Bradley J. Backes, Andrew S. Judd, Mathew Mulhern, Stephen J. Ballaron, Michael A. Stashko, Amanda K. Mika, David W. A. Beno, Glenn A. Reinhart, Ryan M. Fryer, Lee C. Preusser, Anita J. Kempf-Grote, Hing L. Sham, and James M. Trevillyan

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Chart 1. Structures of Selected DPP4 Inhibitors in Clinical Trials

Chart 2

Metabolic Disease Research, Global Pharmaceutical Research and DeVelopment, Abbott Laboratories, Abbott Park, Illinois 60064-6098 ReceiVed August 7, 2006 Abstract: Dipeptidyl peptidase IV (DPP4) deactivates glucoseregulating hormones such as GLP-1 and GIP, thus, DPP4 inhibition has become a useful therapy for type 2 diabetes. Optimization of the high-throughput screening lead 6 led to the discovery of 25 (ABT341), a highly potent, selective, and orally bioavailable DPP4 inhibitor. When dosed orally, 25 dose-dependently reduced glucose excursion in ZDF rats. Amide 25 is safe in a battery of in vitro and in vivo tests and may represent a new therapeutic agent for the treatment of type 2 diabetes.

Dipeptidyl peptidase IV (DPP4,a also known as CD26) is a 110-kDa serine protease that is ubiquitously distributed in the body. It modulates biological activities of a number of peptides by cleaving two amino acid residues from the N-terminus.1 Two of the most prominent endogenous substrates of DPP4 are glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP, also known as gastric inhibitory polypeptide), both of which play important roles in regulating blood glucose levels.2 DPP4 knock-out mice not only showed reduced degradation of both GLP-1 and GIP, but were also healthy without any major immune phenotype (despite the putative importance of DPP4 for immune function), showed improved glucose tolerance, and were resistant to body weight gain on a high-fat diet.3 DPP4-deficient Fisher rats also showed similar phenotypes.4 Furthermore, chronic treatment with DPP4 inhibitors preserved islet function in diabetic mice and improved β-cell survival and islet cell neogenesis in streptozotocin-induced diabetic rats,5 which suggest that DPP4 inhibitors might be able to induce production of new β-cells in type 2 diabetics and thus prevent the progression of the disease. More importantly, several clinical trials in humans show that small-molecule DPP4 inhibitors are well-tolerated, lower blood glucose and/or HbA1c levels, and increase glucose tolerance.6 All the above evidence suggests that DPP4 inhibitors have the potential to be novel, safe, and useful antidiabetic agents.7 * To whom correspondance should be addressed. Phone: 847-935-6254. Fax: 847-938-1674. E-mail: [email protected]. a Abbreviations: DPP4, dipeptidyl peptidase IV; GLP-1, glucagon-like peptide-1; GIP, glucose-dependent insulinotropic polypeptide; OGTT, oral glucose tolerance test; HbA1c, glycosylated (or glycated) hemoglobin A.

Intensive research efforts have resulted in the discovery of a number of potent DPP4 inhibitors.7 Pioneering work led to the identification of first-generation DPP4 inhibitors such as 18 and 29 (Chart 1). They are potent but may lack optimal selectivity10 against other related peptidases such as DPP811 and DPP9.12 Because inhibition of DPP8/9 was linked to toxicity in animal studies,13 efforts were made to identify second-generation inhibitors that are selectiVe. Another study demonstrated that high levels of GLP-1 should be maintained for 24 h for optimal glycemic control.14 These results provided impetus for us and others to identify potential third-generation DPP4 inhibitors that are not only potent and selective, but also possess pharmacokinetic profiles that provide g90% DPP4 inhibition for g24 h for maximal efficacy, particularly in more severe diabetic patients (e.g., HbA1c > 9%).15 Preclinical studies will give indications as to whether this goal is achieved by known DPP4 inhibitors 3,16 4,17 5,18 or our new compound, although a definitive answer will await clinical trials in humans. In this work, cyclohexene-constrained phenethylamine 6 (Chart 2) was identified by high-throughput screening of the Abbott compound collection and subsequently confirmed as a weak DPP4 inhibitor with a Ki of 0.82 µM, as assayed with human DPP4 using Gly-Pro-7-amido-methylcoumarin (Gly-ProAMC) as the substrate.19 After initial SAR exploration revealed that (1) 2,4-dichlorophenyl increases potency over 2-chlorophenyl; (2) the most fruitful position on the cyclohexene ring to modify is C5, as evidenced by compound 7 (Ki < 0.14 µM), acid 8 was identified as a lead with a Ki of 0.045 µM. The general synthesis of cyclohexene-constrained phenethylamines is outlined in Scheme 1. Thermal Diels-Alder reaction between nitrostyrenes 9 and 2-trimethylsiloxy-1,3-butadiene gave racemic ketones 10 after acidic workup. Vilsmeier bromoformylation of ketones 10 furnished bromoaldehydes 11 in modest yields.20 After the aldehydes were reduced to alcohols 12, the bromine atom was removed to afford alcohols 13. The alcohol group was transformed to a mesylate group, which was replaced with amines. Reduction of the nitro group and subsequent reverse-phase HPLC purification afforded amines 8 or 14 as TFA salts. Alternatively, the nitro group of 12b was reduced with zinc, and the resulting amino group was protected with a Boc group to afford 15, which was then debrominated

10.1021/jm060955d CCC: $33.50 © 2006 American Chemical Society Published on Web 10/07/2006

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Journal of Medicinal Chemistry, 2006, Vol. 49, No. 22

Scheme 1a

Letters Table 1. SAR Summary of DPP4 Inhibitorsa

a Values reported are the mean of at least two runs using human DPP4. Potencies were unchanged when rat DPP4 was used. b Racemic. c Chiral. d K in 10% of human serum. i

a Reagents and conditions: (a) trimethylsiloxy-1,3-butadiene, toluene, 120 °C, then TFA; (b) PBr3, DMF/CH2Cl2, 0 °C to rt; (c) NaBH4 or NaBH(OAc)3, EtOH/CH2Cl2; (d) HCO2H, n-Bu3N, cat. Pd(PPh3)2Cl2, DMF, 80 °C; (e) MsCl, CH2Cl2, TEA, 0 °C; (f) R2R3NH, CH2Cl2, TEA; (g) Zn, HOAc/MeOH, reflux; then HPLC; (h) (Boc)2O, THF;. (i) Ar′OH, DBAD, PPh3, toluene, 80 °C; (j) TFA, CH2Cl2, rt; (k) Dess-Martin periodinane, CH2Cl2; (l) NaBH3CN, Ar′NH2; (m) NaClO2, isoprene, NaH2PO4 buffer, DMSO; (n) R4R5NH, TBTU, TEA, DMF, rt; (o) TMSCHN2, MeOH; (p) chiral prep. HPLC; (q) NaOH, THF/H2O, rt.

to alcohol 16. Mitsunobu reaction between 16 and a phenol, then subsequent removal of the Boc group, yielded ether 17. Alcohol 16 was oxidized to aldehyde 18, which underwent reductive amination and subsequent removal of the Boc group to give 19. Aldehyde 18 was further oxidized to acid 20, which was coupled with an amine, followed by removal of the Boc group to provide amide 22. To make optically pure inhibitors, acid 20 was transformed to racemic ester 23, which was resolved by chiral HPLC to give optically pure ester 24. Ester 24 was hydrolyzed under basic conditions to give chiral acid 21, which was converted to optically pure final product 25 in a similar manner to that described for amide 22. Table 1 summarizes the SAR of the DPP4 inhibition and selectivity over DPP8 and DPP9. After dichlorophenyl was switched to a less hydrophobic, equipotent trifluorophenyl at the P1 position, bicyclic amine 14 (Ki ) 12 nM) was identified and showed significantly improved potency over acid 8. Moving the phenyl ring closer to the cyclohexene ring and introducing an amidophenyl group resulted in 19 with a single-digit Ki of 6 nM. Analog 17, with an ether linker, was also very potent, with a Ki of 3.6 nM. However, all of these analogs had limited selectivity over DPP8 and DPP9 (e.g., amine 14 was only 6-fold selective over DPP9). Replacement of the flexible linkers with a more rigid amide significantly improved the selectivity. Thus, amide 22 had a Ki of 4.7 nM against DPP4 and was 1800-fold and 3000-fold selective over DPP8 and DPP9, respectively.

Figure 1. X-ray crystal structure of 25/huDPP4 complex. Colorcoding: all nitrogen atoms are in blue, all oxygen atoms in red and fluorine atoms in cyan. Carbon atoms of 25 are in green, while the carbon atoms of the protein are in gray. The protein surface is shown with atom coloring.

Finally, introduction of a known bicyclic amine16 provided 25 (A-916165), which showed excellent potency (Ki ) 1.3 nM) and selectivity, and the potency was maintained even in the presence of 10% human serum (Ki ) 1.6 nM). Neither was there a change in potency when rat DPP4 was used. The structure of the amide 25/huDPP4 complex was solved by X-ray crystallography. As shown in Figure 1, the trifluorophenyl occupies the hydrophobic S1 pocket.21 The amino group on the cyclohexene ring is in close proximity to the side chains of Glu205 and Glu206 for an electrostatic interaction. The carbonyl oxygen of 25 is oriented toward a water molecule positioned for a bridging hydrogen-bonding interaction with the side chain of Arg669. A favorable hydrophobic interaction of the heterocycle with the side chain of Phe357 is observed. Amide 25 showed superior pharmacokinetic (PK) profiles in all three species tested (Table 2). Amide 25 is characterized by having good exposure across the species, good oral half-lives (5.4 to 6.7 h), large volumes of distribution (7.19 to 3.20 L/kg), and excellent oral bioavailabilities (54 to 104%). Based on the PK in these three species, it is predicted that a 150 mg dose of

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Table 2. Selected PK Parameters of Amide 25 in Rat, Dog, and Monkeya AUC (ng‚hr/g) rat dog monkey

iv po iv po iv po

2920 1948 6019 6285 3557 1905

Cmax (ng/mL)

Tmax (hr)

195

4.7

718 345

0.58 2.7

t1/2 (hr)

Vss (L/kg)

5.3 5.4 7.0 6.7 4.3 6.3

7.19

F (%) 67

4.03 104 3.20 54

Dosed at 5 mg/kg in rats (n ) 6) and 2.5 mg/kg in dogs and monkeys (n ) 6). AUC, area under curve; Cmax, max. concentration; Tmax, time when max. concentration was achieved; t1/2, terminal half-life; Vss, steady-state volume of distribution; F, oral bioavaibility. a

Figure 2. Effects of amide 25 on glucose excursion in female ZDF rats (n ) 10/group).

amide 25 once a day will provide g90% DPP4 inhibition for 24 h in humans.22 Next, we profiled amide 25 in our efficacy model. Briefly, 10-week old, female Zucker diabetic fatty (ZDF) rats were dosed with either vehicle or amide 25 orally after an overnight fast. Four hours later (t ) 0), the rats were allowed free access to a highly palatable, macronutrient balanced food source during the next 4 h. This model is analogous to oral glucose tolerance tests (OGTT) used clinically to routinely evaluate glycemic control, except that the “challenge” is a liquid mixed meal composed of fats, proteins, and carbohydrates, thus a more realistic representation of the nutritional makeup of normal food. Plasma glucose levels were measured at six time points over the course of 4 h, and the change of plasma glucose levels from the baseline is shown in Figure 2. Amide 25 caused a dose-dependent reduction in glucose excursion. The reduction as measured by area under curve (AUC) was 23, 37, and 51% at 0.3, 1.0, and 3.0 mpk, respectively. Consistent with the mechanism of action, active GLP-1 levels (measured at t ) 10 min) increased by 151%, 163% and 291% at 0.3, 1.0 and 3.0 mpk, respectively. Glucagon levels (measured at t ) 30 min) decreased by 36, 46, and 61% at 0.3, 1.0, and 3.0 mpk, respectively. The plasma concentration of amide 25 reached 120 ng/mL (t ) 0), providing 98% (t ) 0) and 96% (t ) 240 min) inhibition of DPP4 at 3 mpk. Besides being efficacious in vivo, amide 25 also possesses an excellent safety profile. It showed no inhibition of major liver metabolic enzymes such as CYP3A4, CYP2D6, and CYP2C9 (IC50 > 30 µM). It was negative in both mini-Ames and clastogenicity tests23 (up to 2000 µg/well). It exhibited no hERG binding (dofetilide Ki > 50 µM, IC50 > 300 µM in patch clamp using HEK 293 cells). When amide 25 was tested against a panel of 74 receptor-binding/ion channel assays (Cerep screening) at a concentration of 10 µM,24 it did not display control-specific binding by 50% or greater in any of the 74 assays. When administered intravenously using an anesthetized, comprehensively instrumented dog model,25 amide 25 exhibited

a benign cardiovascular profile at plasma concentrations vastly higher than those required to achieve efficacy in vivo. As such, amide 25 produced no physiologically relevant effects on mean, systolic, or diastolic arterial pressure, heart rate, cardiac output, pulmonary arterial pressure, pulmonary vascular resistance, or systemic vascular resistance at the highest concentration tested (23.9 ( 1.3 µg/mL) and produced only a small reduction in ventricular contractility at the same concentration. Also, consistent with the absence of hERG binding, amide 25 produced no increase in the QT-interval corrected for changes in heart rate.22 Amide 25 caused no toxicological effects in a 5-day study in rats when dosed up to 1000 mg/kg/day. Taken together, the combination of superb potency and pharmacokinetic profiles offers the potential for amide 25 to reach maximal efficacy achievable by the mechanism of DPP4 inhibition (as limited by the GLP-1 and GIP secretory capacity). Based on its combined profile of excellent potency, selectivity, efficacy, and safety, amide 25 was selected as a drug development candidate (ABT-341). In summary, aided with structural information, we were able to quickly optimize the high-throughput screening lead 5, leading to the discovery of amide 25, a highly potent, selective, orally efficacious, and potentially third-generation DPP4 inhibitor. When dosed orally, amide 25 dose-dependently reduced glucose excursion, increased active GLP-1 levels, and decreased glucagon levels in ZDF rats. Amide 25 is safe in a battery of in vitro and in vivo safety tests and may represent a new therapeutic agent for the treatment of type 2 diabetes. Acknowledgment. The authors thank Larry R. Solomon, Marc R. Lake, Rohinton Edalji, and Elizabeth H. Fry for DPP4 preparation, M. S. Diehl and P. A. Sonders for mini-Ames and micronucleus tests, James Limberis and Zhi Su for hERG binding, Chong Chen for preparative chiral HPLC, Zhengping Tian and Daniel J. Plata for providing 8b, and Michael Duvall for a two-week rat safety study. Supporting Information Available: Experimental procedures including characterization data for compounds and dog cardiovascular safety data. This material is available free of charge via the Internet at http://pubs.acs.org.

References (1) (a) Lambeir, A.-M.; Durnx, C.; Scharpe, S.; Meester, I. Dipeptidylpeptidase IV from bench to bedside: An update on structural properties, functions, and clinical aspects of the enzyme DPP IV. Crit. ReV. Clin. Lab. Sci. 2003, 40, 209-294. (b) Mentlein, R. Dipeptidyl-peptidase IV (CD26)-role in the inactivation of regulatory peptides. Regul. Pept. 1999, 85, 9-24. (2) (a) Mentlein, R.; Gallwitz, B.; Schmidt, W. E. Dipeptidyl-peptidase IV hydrolyses gastric inhibitory polypeptide, glucagon-like peptide1(7-36)amide, peptide histidine methionine and is responsible for their degradation in human serum. Eur. J. Biochem. 1993, 15, 829835. (b) Kieffer, T. J.; McIntosh, C. H.; Pederson, R. A. Degradation of glucose-dependent insulinotropic polypeptide and truncated glucagon-like peptide 1 in vitro and in vivo by dipeptidyl peptidase IV. Endocrinology 1995, 136, 3585-3596. For reviews, see (c) Knudsen, L. B. Glucagon-like peptide-1: The basis of a new class of treatment for type 2 diabetes. J. Med. Chem. 2004, 47, 4128-4134. (d) Deacon, C. F. Circulation and degradation of GIP and GLP-1. Horm. Metab. Res. 2004, 36, 761-765. (3) (a) Marguet, D.; Baggio, L.; Kobayashi, T.; Bernard, A. M.; Pierres, M.; Nielsen, P. F.; Ribel, U.; Watanabe, T.; Drucker, D. J.; Wagtmann, N. Enhanced insulin secrection and improved glucose tolerance in mice lacking CD26. Proc. Natl. Acad. Sci. U.S.A. 2000, 97, 6874-6879. (b) Conarello, S. L.; Li, Z.; Ronan, J.; Roy, R. S.; Zhu, L.; Jiang, G.; Liu, F.; Woods, J.; Zycband, E.; Moller, D. E.; Thornberry, N. A.; Zhang, B. B. Mice lacking dipeptidyl peptidase IV are protected against obesity and insulin resistance. Proc. Natl. Acad. Sci. U.S.A. 2003, 100, 6825-6830.

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(4) Nagakura, T.; Vasuda, N.; Yamazaki, K.; Ikuta, H.; Yoshikawa, S.; Asano, O.; Tanaka, I. Improved glucose tolerance via enhanced glucose-dependent insulin secretion in dipeptidyl peptidase IVdeficient Fisher rats. Biochem. Biophys. Res. Commun. 2001, 284, 501-506. (5) (a) Reimer, M. K.; Holst, J. J.; Ahren, B. Long-term inhibition of dipeptidyl peptidase IV improves glucose tolerance and preserves islet function in mice. Eur. J. Endocrinol. 2002, 146, 717-727. (b) Pospisilik, A.; Martin, J.; Doty, T.; Ehses, J. A.; Pamir, N.; Lynn, F. C.; Piteau, S.; Demuth, H.-U.; McIntosh, C. H. S.; Pederson, R. A. Dipeptidyl peptidase IV inhibitor treatment stimulates β-cell survival and islet neogenesis in streptozotocin-induced diabetic rats. Diabetes 2003, 52, 741-750. (6) (a) Ahre´n, B.; Simonsson, E.; Larsson, H.; Landin-Olsson, M.; Torgeirsson, H.; Jansson, P.-A.; Sandqvist, M.; Bavenholm, P.; Efendic, S.; Eriksson, J. W.; Dickinson, S.; Holmes, D. Inhibition of dipeptidyl peptidase IV improves metabolic control over a 4-week study period in type 2 diabetes. Diabetes Care 2002, 25, 869-75. (b) Ahre´n, B.; Gomis, R.; Standl, E.; Mills, D.; Schweizer, A. Twelveand 52-week efficacy of the dipeptidyl peptidase IV inhibitor LAF237 in metformin-treated patients with type 2 diabetes. Diabetes Care 2004, 27, 2874-2880. (c) Ahre´n, B.; Landing-Olsson, L.; Jansson, P.-A.; Sevensson, M.; Holmes, D.; Schweizer, A. Inhibition of dipeptidyl peptidase-4 reduces glycemia, sustains insulin levels, and reduces glucagon levels in type 2 diabetes. J. Clin. Endocrinol. Metab. 2004, 89, 2078-2084. (d) Ahre´n, B.; Pacini, G.; Foley, J. E.; Schweizer, A. Improved meal-related β-cell function and insulin sensitivity by the dipeptidyl peptidase-IV inhibitor vildagliptin in metformin-treated patients with type 2 diabetes over 1 year. Diabetes Care 2005, 28, 1936-1940. (7) For reviews, see (a) Weber, A. E. Dipeptidyl peptidase IV inhibitors for the treatment of diabetes. J. Med. Chem. 2004, 47, 4135-4141. (b) Wiedeman, P. E.; Trevillyan, J. M. Dipeptidyl peptidase IV inhibitors for the treatment of impaired glucose tolerance and type 2 diabetes. Curr. Opin. InVestig. Drugs 2003, 4, 412-420. (c) Deacon, C. F.; Ahren, B.; Holst, J. Inhibitors of dipeptidyl peptidase IV: A novel approach for the prevention and treatment of type 2 diabetes? Expert. Opin. InVestig. Drugs 2004, 13, 1091-1102. (d) Drucker, D. J. Enhancing incretin action for the treatment of type 2 diabetes. Diabetes Care 2003, 26, 2929-2940. (e) Villhauer, E. B.; Coppola, G. M; Hughes, T. E. DPPIV inhibition and therapeutic potential. Ann. Reports Med. Chem. 2001, 36, 191-200.; (f) Gwaltney, S. L., II; Stafford, J. A. Inhibitors of Dipeptidyl Peptidase 4. Annu. Rep. Med. Chem. 2005, 40, 149-165. (8) Villhauer, E. B.; Brinkman, J. A.; Naderi, G. B.; Burkey, B. F.; Dunning, B. E.; Prasad, K.; Mangold, B. L.; Russell, M. E.; Hughes, T. E. 1-[[(3-Hydroxy-1-adamantyl)amino]acetyl]-2-cyano-(S)-pyrrolidine: A potent, selective, and orally bioavailable dipeptidyl peptidase IV inhibitor with antihyperglycemic properties. J. Med. Chem. 2003, 46, 2774-2789. (9) Augeri, D. J.; Robl, J. A.; Betebenner, D. A.; Magnin, D. R.; Khanna, A.; Robertson, J. G.; Wang, A.; Simpkins, L. M.; Taunk, P.; Huang, Q.; Han, S.-P.; Abboa-Offei, B.; Cap, M.; Xin, L.; Tao, L.; Tozzo, E.; Welzel, G. E.; Egan, D. M.; Marcinkeviciene, J.; Chang, S. Y.; Biller, S. A.; Kirby, M. S.; Parker, R. A.; Hamann, L. G. Discovery and preclinical profile of saxagliptin (BMS-477118): A highly potent, long-acting, orally active dipeptidyl peptidase IV inhibitor for the treatment of type 2 diabetes. J. Med. Chem. 2005, 48, 5025-5037. (10) Mest, H.-J. Dipeptidyl peptidase-IV inhibition can restore glucose homeostasis in type 2 diabetics via incretin enhancement. Curr. Opin. InVest. Drugs 2006, 7, 338-343. (11) Abbott, C. A.; Yu, D. M. T.; Woollatt, E.; Sutherland, G. R.; McCaughan, G. W.; Gorrell, M. D. Cloning, expression, and chromosomal localization of a novel human dipeptidyl peptidase (DPP) IV homolog, DPP8. Eur. J. Biochem. 2000, 267, 6140-6150. (12) Ajami, K.; Abbott, C. A.; McCaughan, G. W.; Gorrell, M. D. Dipeptidyl peptidase 9 has two forms, a broad tissue distrubution, cytoplasmic localization, and DPP-like peptidase activity. Biochem. Biophys. Acta 2004, 1679, 18-28. (13) Lankas, G. R.; Leiting, B.; Roy, R. S.; Eiermann, G. J.; Beconi, M. G.; Biftu, T.; Chan, C.-C.; Edmondson, S.; Feeney, W. P.; He, H.; Ippolito, D. E.; Kim, D.; Lyons, K. A.; Ok, H. O.; Patel, R. A.; Petrov, A. N.; Pryor, K. A.; Qian, X.; Reigle, L.; Woods, A.; Wu, J. K.; Zaller, D.; Zhang, Z.; Zhu, L.; Weber, A. E.; Thornberry, N. A. Dipeptidyl peptidase IV inhibition for the treatment of type 2

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diabetes: Potential importance of selectivity over dipeptidyl peptidases 8 and 9. Diabetes 2005, 54, 2988-2994. Larsen, J.; Hylleberg, B.; Ng, K.; Damsbo, P. Glucagon-like peptide-1 infusion must be maintained for 24 h/day to obtain acceptable glycemia in type 2 diabetic patients who are poorly controlled on sulphonylurea treatment. Diabetes Care 2001, 24, 1416-1421. Balas, B.; Baig, M.; Watson, C.; Dunning, B. E.; Ligueros-Saylan, M.; He, Y.-L.; Wang, B.; Cusi, K.; Foley, J. E.; Defranzo, R. A. Vildagliptin supresses endogenous glucose production (EGP) and increases beta cell function after single dose administration in type 2 diabetic (T2D) patients. American Diabetes Association 66th Scientific Session, Washington DC, 2006, 122-OR. Kim, D.; Wang, L.; Beconi, M.; Eiermann, G. J.; Fisher, M. H.; He, H.; Hickey, G. J.; Kowalchick, J. E.; Leiting, B.; Lyons, K.; Marsilio, F.; McCann, M. E.; Patel, R. A.; Petrov, A.; Scapin, G.; Patel, S. B.; Sinha, R. R.; Wu, J. K.; Wyvratt, M. J.; Zhang, B. B.; Zhu, L.; Thornberry, N. A.; Weber, A. E. (2R)-4-Oxo-4-[3-(trifluoromethyl)5,6-dihydro[1,2,4]triazolo[4,3-a]pyrazin-7(8H)-yl]-1-(2,4,5-trifluorophenyl)-butan-2-amine: A potent, orally active dipeptidyl peptidase IV inhibitor for the treatment of type 2 diabetes. J. Med. Chem. 2005, 48, 141-151. Gwaltney, S. L.; Aertgeerts, K.; Feng, J.; Kaldor, S. W.; Kassel, D. B.; Manuel, M.; Navre, M.; Prasad, S. G.; Shi, L.; Skene, R. J.; Stafford, J. A.; Wallace, M.; Xu, R.; Ye, S.; Zhang, Z. Abstracts of Papers, 231st Meeting of the American Chemical Society, Atlanta, GA, 2006, MEDI-018. Madar, D. J.; Kopecka, H.; Pireh, D.; Yong, H.; Pei, Z.; Li, X.; Wiedeman, P.; Djuric, S. W.; von Geldern, T. W.; Fickes, M.; Bhagavatula, L.; McDermott, T.; Wittenberger, S.; Longenecker, K.; Stewart, K.; Lubben, T. H.; Ballaron, S. J.; Stashko, M. A.; Long, M.; Wells, H.; Zinker, B. A.; Mika, A. K.; Beno, D. W. A.; KempfGrote, A. J.; Polakowski, J.; Segreti, J.; Reinhart, G. A.; Fryer, R.; Sham, H. L.; Trevilliyan, J. M. Discovery of 2-[4-{{2-(2S,5R)-2cyano-5-ethynyl-1-pyrrolidinyl]-2-oxoethyl]amino]-4-methyl-1-piperidinyl]-4-pyridinecarboxylic acid (ABT-279): A very potent, selective, effective, and well-tolerated inhibitor of dipeptidyl peptidase-IV, useful for the treatment of diabetes. J. Med. Chem. Published ASAP, Sept. 23, 2006. For details of assay conditions, see: Pei, Z.; Li, X.; Longenecker, K.; von Geldern, T. W.; Wiederman, P. E.; Lubben, T. H.; Zinker, B. A.; Stewart, K.; Ballaron, S. J.; Stashko, M. A.; Mika, A. K.; Beno, D. W. A.; Long, M.; Wells, H.; Kempf-Grote, A. J.; Madar, D. J.; McDermott, T. S.; Bhagavatula, L.; Fickes, M. G.; Pireh, D.; Solomon, L. R.; Lake, M. R.; Edalji, R.; Fry, E. H.; Sham, H. L.; Trevilyan, J. M. Discovery, structure-activity relationship, and pharmacological evaluation of (5-substituted-pyrrolidinyl-2-carbonyl)2-cyanopyrrolidines as potent dipeptidyl peptidase IV inhibitors. J. Med. Chem. 2006, 49, 3520-3535. For a recent example, see: (a) Knobloch, K.; Keller, M.; Eberbach, W. The synthesis of annulated azepin-3-one derivatives from 1,3,4pentatrienyl nitrones by a heterocyclization-rearrangement sequence. Eur. J. Org. Chem. 2001, 3313-3332. (b) For a review, see: Marson, C. M. Reactions of carbonyl compounds with (monohalo) methyleniminium salts (Vilsmeier reagents). Tetrahedron 1992, 48, 36953726. Refined crystallographic coordinates for the structures of DPP4 complexed with 25 have been deposited in Protein Data Bank (www.rcsb.org) with entry code 2I78. See Supporting Information for details. (a) Bruk, D.; Wedd, D.; Burlinson, B. Use of the Miniscreen assay to screen novel compounds for bacterial mutagenicity in the pharmaceutical industry. Mutagenesis 1996, 11, 201-205. (b) Ciaravino, V.; Suto, M. J.; Theiss, J. C. High capacity in vitro micronucleus assay for the assessment of chromosome damage: results with quinolone/napthyridone antibacterials. Mutat. Res. 1993, 298, 227-236. http://www.cerep.fr. Fryer, R. M.; Preusser, L. C.; Calzadilla, S. V.; Hu, Y.; Xu, H.; Marsh, K. C.; Cox, B. F.; Lin, C. T.; Gopalakrishnan, M.; Reinhart, G. A. (-)-(9S)-9-(3-Bromo-4-fluorophenyl)-2,3,5,6,7,9-hexahydro-thieno[3,2-b]quinolin-8(4H)-one 1,1-dioxide (A-278637), a novel ATPsensitive potassium channel opener: Hemodynamic comparison to ZD-6169, WAY-133537, and nifedipine in the anesthetized canine. J. CardioVasc. Pharmacol. 2004, 44, 137-147.

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